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Year : 2019  |  Volume : 85  |  Issue : 6  |  Page : 569--577

Oral isotretinoin for treating mucocutaneous human papillomavirus infections: A systematic review and meta-analysis

1 Department of Dermatology, Wan Fang Hospital; Department of Dermatology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
2 Department of Dermatology, School of Medicine, College of Medicine, Taipei Medical University; Department of Dermatology, Taipei Medical University Hospital, Taipei, Taiwan

Correspondence Address:
Dr. Yu-Chen Huang
Department of Dermatology, Wan Fang Hospital, Taipei Medical University, 111, Hsing-Long Road Sec. 3, Wenshan District, Taipei City 116
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijdvl.IJDVL_269_18

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Introduction: Some viral warts are refractory to treatment, some others tend to recur. Oral isotretinoin is useful against warts to varying degrees. Objective: To determine the efficacy of oral isotretinoin for treating mucocutaneous human papillomavirus infections. Methods: A systematic review and meta-analysis of studies published from the date of inception of the databases to December 30, 2017 were conducted. Randomized controlled trials or case series with ≥10 patients with mucocutaneous human papillomavirus infection who had received oral isotretinoin treatment were analyzed. The meta-analysis estimated the pooled odds ratio and pooled response rate. Results: The review included eight studies. Trials of oral isotretinoin versus placebo treatment revealed that isotretinoin effectively treated mucocutaneous human papillomavirus infections (odds ratio: 43.8, 95% confidence interval: 9.7–198.8). The pooled estimate of the complete response rate of oral isotretinoin to mucocutaneous human papillomavirus was 67.7% (95% confidence interval: 49.5–81.7%). Another pooled estimation revealed that 83.9% (95% confidence interval: 59.7–94.9%) of patients exhibited at least 50% lesion clearance, whereas 12.3% with complete response experienced recurrence. Limitations: This meta-analysis had a small sample size and high inter-study heterogeneity. Conclusion: Oral isotretinoin is superior to placebo for treating mucocutaneous human papillomavirus infections, particularly plane warts. The recurrence rate and risk of severe side effects are low.


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